HomeMy WebLinkAbout2015-01256 - gas fireplace � { CITY OF ORONO * 2 0 1 5 - 0 1 2 5 6 *
2750 KELLEY PARKWAY DATE ISSUED: 09/29/2015
ORONO,MN 55356-
952 249-4600 FAX: 952 249-4616
ADDRESS : 2560 KELLY AVE
PIN : 20-117-23-11-0007
LEGAL DESC : REG.LAND SURVEY NO.0088
: LOT 000 BLOCK 000
PERMIT TYPE : MECHANICAL(>$500)
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : FIREPLACE-GAS
VALUATION : $ 1,500.00
NOTE: NEW(HEAT N'GLO)GAS FIREPLACE
APPLICANT MECHANICAL 50.00
STATE SURCHARGE MECH(VALUATION) 0.75
CARTER CUSTOM CONSTRUCTION&FP MpIL-IN FEE 2.00
3276 FANUM ROAD#400
VADNAIS HEIGHTS,MN 55110- TOTAL 52.75
(651)653-0190 Payment(s)
Minnesota State License#: CHECK 10019 52.75
mech-MB004750,BUIL-BC632066
OWNER
International Ministerial Fellowshi
P.O.BOX 100
NAVARRE,MN 55392-
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be performed according to
the approved plans and specifications,applicable City approvals,and the
State Building Code. This permit is for only the work described and dces
not grant permission for additional or related work which requires sepazate
permits. All provisions of laws and ordinances goveming this type of work
shall be compied with whether or not specified herein.This permit will
expire and become null and void if construction authorized is not
commenced within 1 SO days of the date of issuance,or if conswction is
suspended for a period of 180 days at any time after work has commenced.
The applicant is responsible for assuring all required inspections aze
requested in conformance with the State Building Code.This permit may be r/-,
revoked at any time for due cause. �/
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Applicant Permitee Signature Date Issued By Signature Date
� FOR CITY U3 QNLY ''
': �O A� City of 4rono '�
�YD P.o.Box� ��,�: � �# 2o�5r-o�a b
2750 Kelley Parkway /���
Crystal Bay,MN 55323 A�mved By_ I�Y 1 Amwmt S:�
Phone(952)249-4600 F�(952)249-4616 E�f�
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f�'�ESH�q`�G CITY OF ORONO—MECHANICAL PERMIT
(All Commercial pemuts must be approved by the Building Official or Inspector and/or Fire Marshall)
GEI'�TERAL IN�QRMATION
1. You may apply for mechanical permits by mail or in person at the City offices. Applications will
be reviewed and a pennit will be issued within two working days.
2. Pernvt cards will be sent by return mail after a review is completed. PERMITS ARE NOT
VALID UNTIL YOU RECEIVE A PERMIT. WORK MUST NOT BEGIN UNTIL THE
PERMIT CARD IS POSTED ON THE JOB SITE.
3. Mechanical Desi�ns—Complete calculations,details and specifications are required for each
heating,ventilation,humidificarion-dehumidification,and air conditioning installarion including
heat loss/heat gain calcularion,design temperatures,equipment ratings and identification as to
type,manufacturer and model. Data shall be presented on form pmvided.
4. When any new construction or remodeling is involved,a separate building permit must be
obtained. �
5. All work must be done in accordance with the Uniform Mechanical Code/State Building Code
requirements.
6. All work must be inspected(rough-in and final). Call(952)249-4600.
(24-48 hour notice required)
7. House Heating Test Record must be submitted before final.
TYPE OF PfiRMIT
, Check All That A l
�esidential ❑Commercial(Approval Required)
�New ❑Additional ❑Repairs ❑Replace
Jab Site/Owner Infc�rmati�n:
Site Address: �
.��G�L.�t-��- g � ��
Owner: �,�` ,1 Mailin Address: �� �Q �(Jt V � I ��
City: � Zip: 1�� �� '
Home Phone: �Ic���b ����� Alternate Phone: ��'7 1 b ��`'✓�J�
Co�ttractor Inforniation:
Contractor: ��(SI/1,��(�U N Contact Person: �
Address: ���`� l.� ���1.� �`���ate Bond#: Y C� �
City: �__��, ip:�V Expiration Date: � �
��
Phone: ���W�� �V l�� Alternate Phone: 1.��1 ���� p�
❑ Insurance—Current:
1
�
Note:All Geothermal Systems will now require a Site Plan&Review by our Building Official.
IS THIS GEOTHERMAL? ❑ Yes ❑No
HEATING SYSTEMS
Quantity:
Make:
Model:
Fuel:
Flue Size:
Input BTLJs:
Output BTLJs:
CFM:
COOLING SYSTEMS
Quantity:
Make:
Model:
Tons:
H.Power
FIREPLACES
� Gas Factory Fireplace Brand Name: ��l.a �
/u Wood Burnin Fir lace
g eP S `
❑ Wood Stove Model No.: V�\YY�\I YLQ,�-��
❑ Wood Stove with Flue/Masonry
VENTILATION ������r ��� ��
❑ No. Kitchen Exhaust duct recirculating cfin
❑ No. Bath Elchaust(must have duct outside) cfm
❑ No. Other Fans: Locations cfm
FUEL STORAGE (Must be approved by Fire MarshaU if proposing to abandon tank in plac�)
❑ Installation ❑ Removal
Fuel Oil: gallons ❑ Underground ❑Inside ❑Outside
LP Gas: gallons
Other:
GAS LINE ONLY
❑ Outdoor Grill ❑ Other/List What&Where:
2
.
❑ Yes,this section applies
The replacement of a Residential fixture or appliance that meets all three of the following requirements:
1. Does not require modification to electrical or gas service.
2. Has a total cost of$500.00 or less;excludin¢the cost of the fixture or appliance:and
3. Is improved,installed or replaced by the homeowner or licensed contractor.
Skip next section,if this applies; Cost of Permit $ 15.00
State Surchazge $ 1.00
Mail-In Fee(If Applicable) $ 2.00
Total Permit Fee $
If above does not apply;follow guidelines below:
1. CONTRACT PRICE *is 1.25%of contract price L��inimum Fee of 550.00)
V x.0125$
(c ct price) (minimum$SO.OfI)
2. STATE SURCHARGE
x.0005 $
(coniract price)
3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00
4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ , ��
■ '� CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the
permitted work including materials,labor,profit,and other fixed costs. It is the amount to be charged
to the customer for the work done. If any material, equipment, labor or installations are furnished by
the owner,tenant or any other party,the reasonable market value of such items must be added to the
estimated cost or contract price for permit fee purposes. In the event that there is a dispute on the
amount of the job cost, the City may request the submission of a signed copy of the actual contract.
�� �.
The undersigned hereby applies to the City for issuance of a Mechanical Permit, agrees to do all
work in strict accordance with the ordinances of the City and the regulations of the State of
Minnesota, and certifies that all statements made on this application are complete, true and
conect.
ApplicanYs Signature: Date: � 2 ` l�
3
���
��) DATE TIME
CITY OF ORONO CALLED IN (�s
INSPECTION NOTICE �. SCHEDULED ����C�
PERMIT NO.��%��'GI �Z(r,(p COMPLETED
ADDRESS � ��
OWNER TELEPHO E NO. �O
CONTRACTOR -��- ��
� DESCRIPTION
��.
ly ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL
Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING
Q ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL
Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS
� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
W ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL
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� ❑ DEMO-SITE ❑ SEPTIC I TALL
2 OWNERICONTRACTOR TO MEET YOU:_YES�O
y COMMENTS: ��J `�.�� ►JU.� I�
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W WORKSATISFACTORY:PROCEED PROJECTCOMPLEfE
� � RRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
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� ❑CORRECT WORK,CALL FOR REtNSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ pHOTO TAKEN
INSPECTOR WILL REfURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advan ) 249-4600
OwnerlContractor on site:
inspector.
White Copyllnspector's File Cenary CopylSfte Notice